title: [Shortest route for in situ left thoracic artery to left anterior descending coronary artery].
abstract: For coronary artery bypass grafting, the internal thoracic artery (ITA) graft carries a greater long-term patency and a decreased need for reoperation when compared with the saphenous vein graft. However, the number and length of ITAs limit their use. In an effort to extend the use of the ITA and to improve patency, we evaluated the shorter course from the left ITA (LITA) origin to the left anterior descending coronary artery (LAD). We compared the distance using the conventional route over the lung (20 patients) with that using the newly-devised route medial to the lung and through the pericardial incision (20 patients). The distance using the route medial to the lung and through the pericardial incision was 12.6 +/- 1.4 cm (mean +/- SD), which was shorter compared with 15.1 +/- 1.1 cm of the route over the lung (p less than 0.01). And also the route medial to the lung and through the pericardial incision could avoid the danger of strectching or kinking by the inflated left lung. From these results, we concluded that the use of the route medial to the lung and through the pericardial incision was better method of extending the use of the in situ LITA to LAD.
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Shimonoseki General Hospital, Yamaguchi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Tanimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Sakata
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Misumi
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D012501:Saphenous Vein / Q000637:transplantation; D014654:Vascular Patency